GNU Health Decision Support on Prescription Writing

In this entry I will briefly talk about how GNU Health can help the professional in making the best decision, and how to minimize mistakes.

I will focus in prescription writing and how we're incorporating DS (Decision Support) to GNU Health.

GNU Health uses the WHO (World Health Organization) essential list of medicines by default, so you already have a very nice and updated set for your daily practice.

The medicament model incorporates the pregnancy category. In this case, we have opted for the FDA pregnancy categories, but you can configure GNU Health to use another categorization system.

In the next screenshot, you can see a list of medicines, with an specific color, that specifies the pregnancy category. That visual aid quickly differentiate those medicaments to avoid use in pregnancy (all in categories D and - especially category X ), from those that will be generally safe to use (such as those in categories A and B ).

So, from that very starting point, you have GNU Health assisting you visually to choose the right drug.

After you have finished the prescription writing process, GNU Health does different checks in relation to the patient you are writing the prescription.

In its simplest form, let's check the next example. GNU Health checks the patient sex and age, and determines the risks associated to that patient. In this case, the patient belongs to a potential childbearing / fertile group. So, GNU Health will set a verification flag and will remind the health professional to ask the patient basic but very important questions about the patient status, such as :

- Is she pregnant

- Is the patient planning to become pregnant

- In the case of pregnancy, in which trimester is she in

In other words, GNU Health will stop us from making the prescription until we have verified that what we are prescribing is an educated and thoughtful decision, the best possible for our patient.

By the way GNU Health keeps record of the gynecological and obstetric status of the patient, but this might be the first encounter or her medical record might be in another center that has some dark privative software that does not share the information ;-)

GNU Health prescription verification process in specific patients

Of course, theultimate decision will always be on the doctor. This type of Decision support we aim to minimize common pitfalls due to fatigue, inexperience, etcetera that can jeopardize the wellbeing of the patient.

Many thanks to Dr. Christoph Larsen and Andrew Gledhill (NHS) that have helped me in the process.

We will definitely enhance the Decision Support from GNU Health, such as in the clinical context, always keeping simplicity and just as a guiding / aiding tool for the professional.

About GNU Health

GNU Health is a free Health and Hospital Information System that provides the following functionality :

Electronic Medical Record (EMR)

Hospital Information System (HIS)

Health Information System

GNU Health is an official GNU Package , chosen by Richard Stallman, and is part of GNU Solidario. GNU Solidario is a NGO that delivers education and health to emerging economies with free software.

GNU Health is the Hospital Information System chosen by the United Nations International Institute of Global Health.

In this view, it's easy to look for patient's locations and status in the hospital. The colors visually differentiate the type of admissions.

We have also improve other sections, like vaccinations. Thanks to Andrew Gledhill (NHS) who proposed the addition of the vaccine lot and expiration date. Actually, the vaccine is integrated to the product, so all the production lot, traceability, and procurement is automated. Special controls for vaccine expiration dates have been put in place now.

I could write many pages, but it all comes down to one concept: ethics.
When I talk about Free Software, I talk about not only about freedom, but also community and good will from the software author. The latter probably is the most important one.
You write Free Software because you want to contribute to the community. It's an act of social activism. It's about sharing and helping out.
This April I got a mail from Chris Larsen, a doctor working in Rwanda, where he was asking OpenERP the scripts to upgrade to 6.x, since they needed to have the latest Medical version. The response he got was that the scripts were not publicly available anymore. If they wanted to upgrade, they would have to pay a support contract to OpenERP. This is the typical example of a vendor lock-in. They change the rules (even the license) and then the user becomestheir prisoner.
That very same day I started the implementation of GNU Health (previously called "medical") in the Tryton platform. B…